Tricity Pain Associates is a leading chronic pain management company that serves our state of Texas. We help relieve people of chronic pain, and help them move towards a better quality of life. Our pain management doctors and staff are a dynamic team of professionals, who excel in keeping our patients healthy and pain free.

We are seeking a full-time Insurance Accounts Receivable Specialist for our Revenue Cycle Team. The ideal candidate will obtain prior authorizations for all managed care plans to include Medicare/Medicaid plans. We are seeking a candidate that can function in an interactive and fast-paced environment, all while providing dynamic customer service!

Responsibilities

· Verification of insurance benefits if missed by front office.

· Able to research denied CPT code/dx codes with comparison to the LCD/NCD requirements.

· Effectively identifies trends and inhibit timely payment.

· Monitors accounts receivable follow-up work queues and reports.

· Work an average of 40 to 80 denials per day based on supervisor requirements and accounts assigned.

· Works closely with insurance carriers for reimbursement requirements to ensure timely payment.

· Reviews outstanding AR accounts and contacts insurance for reimbursement explanation.

· Provides clear and accurate documentation of all contacts with internal or external customers.

· Quickly becomes familiar with duties and performs them independently, accurately, efficiently, promptly, and recognizing their importance and relationship to patient care.

· Consults with appeals department for disputed medical necessity denied claims.

· Works and Understands electronic claim interchange and the life cycle of the claims process.

· Ability to read and interpret electronic remittance advice.

• Manages relationships with third party payers, hospital departments, and patients to obtain information required for account receivable resolution.

· Takes Incoming calls from payors, patients, and all clinical personnel.

· Regular attendance and punctuality.

· Contributes to team effort by accomplishing related results as needed.

• Utilizes internal and payer technology and resources to support account resolution activities.

· Ensures that all processing and reporting deadlines are consistently achieved.

· Adhere to all standard operating procedures.

· Performs any other functions as required by management.

Qualifications and Education Requirements

· Minimum 2 years’ experience in Revenue Cycle Insurance Collection Processes.

· Understanding of Medicare, Medicaid, and third-party billing/coding guidelines.

· Experience with multiple billing and EMR Systems.

· Experience with computerized billing software, EMR, and interpreting EOBs.

· Working knowledge of ICD-9/ICD-10, CPT, HCPCS, and CPT coding.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Ability to commute/relocate:

• San Antonio, TX 78258: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

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